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中华眼科医学杂志(电子版)

中华眼科医学杂志(电子版) ›› 2017, Vol. 07 ›› Issue (04) : 165 -170. doi: 10.3877/cma.j.issn.2095-2007.2017.04.004

所属专题： 文献；

论著

眼周轮匝肌联合皱眉肌、降眉肌及额肌注射A型肉毒毒素治疗良性特发性眼睑痉挛的疗效观察
李婷1,†(), 银丽2   
  1. 1. 830001　新疆维吾尔自治区人民医院眼科
    2. 830000　新疆乌鲁木齐市普瑞眼科医院眼整形及泪道科
  • 收稿日期:2017-07-15 出版日期:2017-08-28
  • 通信作者: 李婷
  • 基金资助:
    新疆少数民族科技人才特殊培养科研专项基金(201523123)

To investigate the efficacy of botulinum orbicularis toxin type A combined with orbicularis oculi muscle, orbicularis oculi muscle and frontalis muscle injection in the treatment of benign idiopathic blepharospasm

Ting Li1,†(), Li Yin2   

  1. 1. Department of Ophthalmology, Xinjiang Uygur Autonomous Region Hospital, Urumqi 830001, China
    2. Department of ocular surgery and lacrimal passage, Xinjiang Uygur Puri Eye Hospital, Urumqi 830000, China
  • Received:2017-07-15 Published:2017-08-28
  • Corresponding author: Ting Li
  • About author:
    Corresponding author: Li Ting, Email:
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引用本文：

李婷, 银丽. 眼周轮匝肌联合皱眉肌、降眉肌及额肌注射A型肉毒毒素治疗良性特发性眼睑痉挛的疗效观察[J]. 中华眼科医学杂志(电子版), 2017, 07(04): 165-170.

Ting Li, Li Yin. To investigate the efficacy of botulinum orbicularis toxin type A combined with orbicularis oculi muscle, orbicularis oculi muscle and frontalis muscle injection in the treatment of benign idiopathic blepharospasm[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2017, 07(04): 165-170.

目的

探讨眼周轮匝肌联合皱眉肌、降眉肌及额肌注射A型肉毒毒素治疗良性特发性眼睑痉挛的疗效。

方法

收集2016年6月至12月于新疆维吾尔自治区人民医院诊断为中重度良性特发性眼睑痉挛的患者40例(80只眼)的临床资料。将全部病例分为观察组和对照组两组。其中，观察组为20例(40只眼)，采用A型肉毒毒素局部注射治疗，注射点为眼周轮匝肌；对照组为20例(40只眼)，采用A型肉毒毒素局部注射治疗，注射点为眼周轮匝肌、皱眉肌、降眉肌及额肌。注射治疗结束后，对治疗疗效进行评估。疗效评价指标分为完全缓解、显著缓解、部分缓解及无缓解四项。依据面部皱纹的评分法对皱纹进行量化评分，0分无皱纹、1分为轻度皱纹、2分为中度皱纹、3分为中重度皱纹及4分为重度皱纹。两组A型肉毒毒素用量的比较采用t检验。治疗效果和面部皱纹评分的比较采用Kruskal－Wallis H秩和检验。上睑下垂程度的组间比较采用卡方检验。

结果

观察组A型肉毒毒素的用量为(40.0±2.5)U，对照组A型肉毒毒素的用量为(32.0±2.5)U，二者比较差异有统计学意义(t＝10.12，P<0.05)。观察组完全缓解、明显缓解及部分缓解率分别为60%、20%及20%；对照组分别为75%、20%及5%，两组效果评价经Kruskal－Wallis H秩和检验，差异无统计学意义(Hc＝－1.18，P>0.05)。观察组出现不同程度上睑下垂3例，对照组出现1例，二者差异无统计学意义(χ2＝－1.18，P>0.05)；观察组和对照组术后面部动力性皱纹评分比较，对照组评分要高于观察组，二者差异具有统计学意义(Hc＝－5.49，P<0.05)。

结论

与选择在眼周轮匝肌单独注射A型肉毒毒素相比，选择在眼周轮匝肌联合皱眉肌、降眉肌及额肌注射A型肉毒毒素的方法治疗特发性眼睑痉挛更加有效。

关键词: 良性特发性眼睑痉挛, A型肉毒毒素, 注射位点, 局部注射
Objective

To investigate the efficacy of orbicularis oculi muscle joint muscles between the frontal muscle and injection of botulinum toxin A in the treatment of benign idiopathic blepharospasm.

Methods

Methods the clinical data of 40 patients (80 eyes) diagnosed with moderate and severe benign blepharospasm in the the Xinjiang Uygur Autonomous Region people's Hospital from June to December 2016 were analyzed retrospectively. Among them, the observation group was 20 cases (40 eyes), using botulinum toxin A injection for treatment, the eye orbicularis muscle; the control group of 20 cases (40 eyes), using botulinum toxin A injection for treatment, eye orbicularis, corrugator and procerus and the amount of muscle. The therapeutic efficacy was evaluated at the end of the injection treatment. The therapeutic effects were divided into complete remission, significant remission, partial remission and no remission. According to the scoring method of facial wrinkles, the score of the wrinkles was quantified. There were no wrinkles in 0, 1 for mild wrinkles, 2 for moderate wrinkles, 3 for moderate and severe wrinkles, and 4 for severe wrinkles. A test was used t for the comparison of botulinum toxin type . The effect of treatment and facial wrinkles score test by comparison with Kruskal-Wallis H. The comparison between the groups of upper eyelid ptosis was made by chi square test.

Results

The observation group of botulinum toxin type A dosage (40±2.5) U , the control group of botulinum toxin A was (32±2.5) U, the difference between the two groups was statistically significant (t =10.12, P<0.05). The observation group complete remission, partial remission and relieve rate were 60%, 20% and 20%; the control group were 75%, 20% and 5%, evaluate the effects of the two groups were tested (Hc=-1.18, P>0.05), the difference was not statistically significant. The observation group appeared different degree of ptosis in 3 cases, the control group of 1 cases, there was no significant difference between the two groups comparison of facial wrinkles score in the observation group and control group, the control group was higher than that of the ob(χ2 =-1.18, P>0.05); servation group (Hc=-5.49, P<0.05) two the difference was statistically significant (Hc = 5.49, P<0.05).

Conclusion

Compared with the choice of botulinum neurotoxin alone in the orbicularis oculi muscle, the treatment of botulinum toxin type A in the orbicularis oculi muscle, the orbicularis oculi muscle, the descending eyebrow muscle and the frontal muscle was more effective in the treatment of botulinum toxin type A.

Key words: Benign idiopathic blepharospasm, Botulinum toxin type A, Injection site, Local injection
表1 观察组与对照组患者面部皱纹评分的比较[%(例数/总例数)]
组别 患者面部皱纹评分
1分 2分 3分 4分
观察组 60(8/20) 20(12/20) 0(0/20) 0(0/20)
对照组 0(0/20) 5(1/20) 25(5/20) 70(14/20)
Hc值 －5.49
P值 <0.05
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